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Title: Transbronchial Lung Cryobiopsy in Patients with Interstitial Lung Disease: A Systematic Review.
Austin Authors: Kheir, Fayez;Uribe Becerra, Juan Pablo;Bissell, Brittany D;Ghazipura, Marya;Herman, Derrick D;Hon, Stephanie M;Hossain, Tanzib;Khor, Yet H ;Knight, Shandra L;Kreuter, Michael;Macrea, Madalina;Mammen, Manoj J;Martinez, Fernando J;Poletti, Venerino;Troy, Lauren;Raghu, Ganesh;Wilson, Kevin C
Affiliation: Respiratory and Sleep Medicine
Royal Prince Alfred Hospital, 2205, Respiratory Medicine, Sydney, New South Wales, Australia
Beth Israel Deaconess Medical Center, 1859, Division of Thoracic Surgery and Interventional Pulmonology, Boston, Massachusetts, United States
University of Kentucky, 4530, Lexington, Kentucky, United States
New York University Langone Health, Epidemiology and Biostatistics, New York, New York, United States
The Ohio State University Wexner Medical Center, Pulmonary, Critical Care, and Sleep Medicine, Columbus, Ohio, United States
Boston University School of Medicine, 12259, The Pulmonary Center, Boston, Massachusetts, United States
New York University Langone Health, Department of Medicine, New York, New York, United States
National Jewish Health, Library & Knowledge Services, Denver, Colorado, United States
Center for interstitial and rare lung diseases, Pneumology, Thoraxklinik, University of Heidelberg, Member of the German Center for Lung Research Germany, Heidelberg, Germany
University of Virginia, Medicine, Charlottesville, Virginia, United States
University at Buffalo, Medicine, Buffalo, New York, United States
Cornell Medical College, New York, New York, United States
University of Washington Medical Center, 21617, Division of Pulmonary and Critical Care Medicine, Seattle, Washington, United States
Boston University, Medicine, Boston, Massachusetts, United States
Salem VAMC, Pulmonary/Critical Care/Sleep/Palliative, Salem, Virginia, United States
Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Tulane University School of Medicine, Pulmonary Diseases, Critical Care and Environmental Medicine, New Orleans, Louisiana, United States
American Thoracic Society, 44197, Documents Department, New York, New York, United States
Issue Date: Jul-2022
Date: 2022
Publication information: Annals of the American Thoracic Society 2022; 19(7):1193-1202
Abstract: In 2018, a systematic review evaluating transbronchial lung cryobiopsy (TBLC) in patients with interstitial lung disease (ILD) was performed to inform American Thoracic Society (ATS), European Respiratory Society (ERS), Japanese Respiratory Society (JRS), and Asociación Latinoamericana del Tórax (ALAT) clinical practice guidelines on the diagnosis of idiopathic pulmonary fibrosis (IPF). To perform a new systematic review to inform updated guidelines. Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CCTR) were searched through June 2020. Studies that enrolled patients with ILD and reported the diagnostic yield or complication rates of TBLC were selected for inclusion. Data was extracted and then pooled across studies via meta-analysis. The quality of the evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Histopathologic diagnostic yield (number of procedures that yielded a histopathologic diagnosis divided by the total number of procedures performed) of TBLC was 80% (95% CI 76-83%) in patients with ILD. TBLC was complicated by bleeding and pneumothorax in 30% (95% CI 20-41%) and 8% (95% CI 6-11%) of patients, respectively. Procedure-related mortality, severe bleeding, prolonged air leak, acute exacerbation, respiratory failure, and respiratory infection were rare. The quality of the evidence was very low due to the uncontrolled study designs, lack of consecutive enrollment, and inconsistent results. Very low-quality evidence indicated that TBLC has a diagnostic yield of approximately 80% in patients with ILD, with manageable complications.
DOI: 10.1513/AnnalsATS.202102-198OC
ORCID: 0000-0002-4192-5080
Journal: Annals of the American Thoracic Society
PubMed URL: 35499855
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

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